Adenoiditis in children

Adenoiditis in children is a fairly frequent disease of childhood. Children tend to hypertrophy of the throat tonsill, especially the nasopharyngeal, the so-called adenoids. From 5 to 25% of children under 14 years old have hypertrophy of adenoid tissue. During puberty adenoids usually atrophy.

[1], [2], [3], [4], [5]

What causes adenoiditis in children?

Acute adenoiditis in children causes streptococci, staphylococci, pneumococci, viruses. Features of immunological reactivity of children and repeated acute inflammation of adenoids predispose to the development of chronic adenoiditis.

In children with allergic diathesis, exogenous non-infectious allergens (food, household) play an important role in the development of hypertrophy of adenoid tissue and chronic adenoiditis.

Symptoms of adenoiditis in children

Adenoiditis in children of acute form is essentially a retro-vascular angina and has all the clinical signs of acute infectious inflammation: fever, nasal congestion, pain in the ears, paroxysmal cough at night, an increase and soreness of the cervical and maxillofacial lymph nodes.

Clinical symptoms of chronic adenoiditis in children are due to the fact that enlarged adenoids complicate or completely exclude nasal breathing, ventilation of auditory tubes, disrupt the function of the pharynx, which adversely affects the overall development of the child. There are stagnant phenomena in the nose and paranasal sinuses, leading to swelling and chronic inflammation of the nasal mucosa, the accumulation of thick viscous mucus.

The flow of mucopurulent-purulent discharge into the larynx, dryness of the mucous pharynx and larynx due to breathing through the mouth causes a persistent reflex cough, especially at night. Children sleep with their mouths open, often sleep accompanied by snoring. In the morning the children stand up sluggish, apathetic, with a headache. There is a violation of phonation, the voice loses its sonority, takes a deafening shade - closed nasal. By closing the openings of the auditory tubes, enlarged adenoids sometimes lead to a significant decrease in hearing, relapsing otitis and sinusitis. This determines the absent-mindedness and inattention of the child, the delay in the development of speech, the difficulty in teaching in school.

Prolonged adenoiditis in children leads to the formation of an adenoid face, open mouth, smoothed nasolabial folds, thickened wings of the nose, wedge shape of the upper jaw, improper disposition of the teeth due to the narrow alveolar process of the upper jaw, an indifferent expression.

When breathing through the mouth, cold, un-moistened and insufficiently purified air enters the lower respiratory tract, which leads to frequent respiratory diseases.

Diagnosis of adenoiditis in children

The diagnosis is based on anamnesis, external examination of the child, and data from the posterior or anterior rhinoscopy. The magnitude of hypertrophy of adenoids is determined by three degrees.

If allergic etiology of adenoiditis is suspected, an allergic examination is performed.

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Treatment of adenoiditis in children

Acute adenoiditis in children is treated locally with vasoconstrictive drops, 1-2% solution of protargol. Prescribe antibiotics: amoxicillin, augmentin, smallpox, preparations of macrolides.

In chronic adenoiditis, infectious etiology is carried out in children with adenotomy, indications to which are determined by the degree of adenoid hypertrophy and the presence of complications of adenoiditis (repeated otitis, hearing loss, sinusitis, etc.). Before the operation, a course of local conservative treatment, sanitation of the oral cavity is performed.

With allergic etiology of adenoid tissue hypertrophy to adenotomy should be treated with caution, since the removal of lymphoid tissue of the upper respiratory tract can lead to a weighting of the course of respiratory allergosis. Such adenoiditis is treated in children, starting with the elimination measures, local therapy, including the administration of sodium cromoglycate preparations in the nose, the course of basic therapy with antihistamine drugs of the second generation (ketotifen, zirtek).